Pandemic risks sustained by the Severe Acute Respiratory Syndrome Corona- Virus 2 (SARS-CoV-2) have a negative impact on solid organ transplantation activity worldwide. The donor-derived infection risk for immunosuppressed recipient impacted negatively on organ donation and transplant activity, due to its possible unfavorable prognosis. In the difficult pandemic scenario, also the transplant community faced the problem according to the new evidences about SARS-CoV-2 infection and its related risks. National Transplant Community firstly allowed the organ transplantation from SARS-CoV-2 infected donor only in case of emergency, when patient survival in waiting list could compromised the prognosis quoad vitam. Vaccination campaign and the possibility for risk categories to have an extra booster dose, help the transplant candidate to create a good immune coverage against community contagious risk but also against donor-derived risks infection. In this case we describe a successful liver transplantation from a donor died for secondary cause of SARS-CoV-2 to a recipient with a positive history for SARS-CoV-2 infection and two doses of vaccine. In the case described, there was considered the hypothetical risk of donorderived infection risk from SARS-CoV-2. Nevertheless, urgent hepatic transplantation was motivated by the very serious prognosis of the recipient on the active list, and the recipient was protected by specific, circulating, and cell-mediated immunity. Post-operative course was uneventful. Considering the many clinical experiences included the one described, we suggest to review the indication for organ allocation in case of organs coming from SARS-CoV-2 deceased donors.
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Miggino et al. (2024) studied this question.
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